Doctor Fired After Maternal and Infant Deaths at Brooklyn’s Woodhull Hospital

Woodhull Medical Center has become a symbol of racial disparities in maternal mortality in New York City.

A baby died during childbirth late last year after medical staff at a Brooklyn hospital appeared to ignore worrying signs for several hours, a new report by state health investigators has found.

Two weeks later, the same doctor involved in the infant’s death was also involved in the death of a mother who gave birth at the hospital, Woodhull Medical Center in Bedford-Stuyvesant, according to the report.

The doctor, Ronald Daniel, 72, was fired in December after the mother’s death, his employer said. But the two fatal incidents on the same labor and delivery floor highlighted major concerns about the hospital, which state health officials declared to be in “immediate jeopardy” — an administrative finding that a hospital poses a danger to patients.

The doctor was not the first at Woodhull to be fired following a maternal death in recent years. And this is not the first time regulators have concluded that problems on the hospital’s labor and delivery floor led to a death.

The “jeopardy” finding was quickly lifted after Woodhull promised several changes. In a statement, the city’s public hospital system said it had “revamped and enhanced its protocols across its obstetrics and anesthesiology departments.” A person who answered a call to Dr. Daniel’s phone number hung up when asked for comment.

Woodhull, one of the city’s 11 public hospitals, has long been regarded as one of the weaker institutions in the public hospital system. It has become a symbol of what city officials call New York’s “maternal health crisis,” which has especially affected women of color. In New York City, Black women are nine times more likely than white women to die during pregnancy or childbirth, a far starker disparity than the national one.

A growing body of evidence paints Woodhull’s labor and delivery floor as a place where deadly mistakes keep occurring, with insufficient efforts to figure out why. In recent years Woodhull has been the site of two maternal deaths that regulators blamed on troubling errors by medical staff.

In 2020, Woodhull removed an anesthesiologist, Dr. Dmitry Shelchkov, after he botched an epidural, the first in a cascade of errors that resulted in the death of Sha-Asia Semple, a first-time mother.

The death of Ms. Semple, who was Black, sparked a demonstration outside the hospital and underscored the racial disparities surrounding childbirth in New York.

The public hospital system said in its statement that it had instituted a stronger process for reviewing bad outcomes. Woodhull also recently hired a new chief medical officer and a new head of obstetrics. Some women have sought it out as a place to give birth because midwives play an unusually large role on the labor and delivery floor, providing a less medicalized experience. More than 1,000 babies are delivered at Woodhull each year; about 85 percent are Black or Hispanic.

But the 10-page government report — which includes the findings by state Health Department investigators, and Woodhull’s response — describes two incidents at Woodhull involving pregnancies over the past six months: a uterine rupture that led to the death of a baby, and, two weeks later, the death of a mother during an emergency C-section.

The first case involved a woman who had arrived at the hospital on Oct. 29, 2023. She had labored for 24 hours in the care of nurses and midwives at the hospital, and at times the fetal heart rate had dropped, a signal that something could be wrong. She was attempting a vaginal delivery, but had previously given birth by C-section. That can involve a small risk — perhaps under 1 percent, though estimates vary — of a uterine rupture, when the earlier C-section scar rips. A drop in the fetal heart rate is often a key warning sign.

Investigators concluded that the nurses and midwives caring for her did not notify the attending physician until more than 12 hours after the first worrisome signs. At that point, around 1 a.m. on Oct. 31, a doctor recommended an emergency C-section. During the C-section, it became clear that the woman’s uterus had ruptured, injuring her bladder as well.

The report said little about the infant other than to note that the baby did not live. “Resuscitation efforts were unsuccessful,” the report said. The mother’s uterus was removed, the report said.

The hospital’s chief medical officer, Ross MacDonald, later told investigators that the emergency C-section should have happened earlier, according to the report.

The document does not identify the mother, and does not state whether Dr. Daniel was the obstetrician who ultimately performed the C-section, or if he had been involved in the case only in the preceding hours. But the report noted that the doctor involved was fired in response to two separate cases, and a health official confirmed that the doctor described in the report was Dr. Daniel.

A spokesman for NYU Langone Health, which supplies many of the doctors at Woodhull, confirmed that Dr. Daniel was fired on Dec. 5 — the same date provided for the doctor’s termination in the government report.

The infant death revealed some uncertainty on the labor and delivery floor about who — midwives or doctors — was primarily responsible for patients who were trying for a vaginal birth after a C-section. The two midwives involved were both placed on a monitoring program to evaluate their competence.

Two weeks later, on Nov. 13, a 30-year-old mother of two, Christine Fields, had an emergency C-section amid signs of growing fetal distress. The obstetrician, Dr. Daniel, later filed a report saying there had been “no intraoperative surgical complications” during the C-section, according to the investigators’ findings, suggesting that all was well.

It was not. Investigators later learned the C-section incision was too long, which can occur from the scalpel or a tear when pulling out the baby. During the C-section, doctors had patched up the injury with sutures and saw no further bleeding at the time, Dr. MacDonald, the chief medical officer, later wrote in an email to the medical examiner’s office.

But Dr. Daniel did not mention the injury in his surgical report or to the medical staff providing post-delivery care, as is required.

An extension of the incision can be “one of the more frightening complications of a C-section” because it can tear into major blood vessels on the uterine wall, raising the risk of hemorrhage, said Dr. Amos Grunebaum, a longtime obstetrician and professor at the Zucker School of Medicine at Hofstra University, who had no involvement in the case.

An assistant surgeon later acknowledged to supervisors that an injury had occurred during the C-section, which the autopsy report would confirm. But the staff who cared for Ms. Fields after the C-section seemed to have had no idea. She began to bleed internally, and later died.

Dr. Daniel is well-regarded by his peers, who described him as caring and competent. Several colleagues said they were unaware of a larger pattern of problems beyond these two cases. In an email, the public hospital system said it had made “many significant improvements in the area of maternal health” and had increased its use of simulations to help train labor and delivery floor staff on how to respond to various emergencies. The C-section rate at the city’s public hospitals is consistently lower than the state average, an indicator linked to safety, the email said.

Doctors often note that bad outcomes sometimes happen on the labor and delivery floors of even the best hospitals.

“Things can happen even when you do things perfectly well,” Dr. Grunebaum said. “But they didn’t do things perfectly well.”